Apocrine gland carcinoma of the axilla - Review of the literature and recommendations for treatment

Apocrine gland carcinoma is a rare form of sweat grand neoplasm with a dist inctive cytologic appearance. Although the region of the axilla remains the most common site for these tumors, apocrine gland carcinoma of the anogeni tal region, eyelid, ear, chest, wrist, lip, foot, toe, and finger have been reported. Classically, these slow-growing lesions present as painless, col orless or reddish, firm or cystic nodules. More than half of the reported p atients with apocrine carcinoma had lymph node metastases at the time of di agnosis. Wide local excision is standard therapy for these lesions. A thera peutic lymph node dissection is indicated for confirmed lymph node metastas es and may have a role in the setting of a large or highly aggressive tumor with narrow surgical margins. Although apocrine gland carcinoma responds p oorly to chemotherapy, adjuvant radiotherapy may be used in advanced local or regional disease. The authors describe a 69-year-old man with a large re current apocrine gland carcinoma of the axilla treated with en bloc excisio n with axillary dissection and offer a pertinent review of the English lite rature and recommendations for treatment.